Hemostasis and periventricular-intraventricular hemorrhage of the newborn
M. Van de Bor, E. Briet, F. Van Bel and J. H. Ruys
In a prospective study we analyzed the role of coagulopathy in the
development of periventricular-intraventricular hemorrhage (PIVH) in 49
consecutively admitted preterm infants of less than 34 weeks' gestation by
serial ultrasound examinations and coagulation assays. In 20 patients (41%)
PIVH was detected. On the day of birth, patients with PIVH had
significantly lower levels of factor V than did the patients without PIVH,
but all other clotting factors gave similar results, and on the third and
fifth days all results were similar, including those for factor V. Even the
small subgroup of infants who subsequently developed grade IV hemorrhage
did not have a more severe coagulopathy than the other infants, although
they had significantly lower levels of platelets and of factor VII at
birth. We conclude that coagulopathy does not play an important role in the
etiology of PIVH. Standard doses of 10 mL/kg of fresh-frozen plasma,
administered to increase the low levels of clotting factors, did not
prevent extension of the hemorrhage.
